Psychological and Socio-Economic Factors Affecting Social Sustainability through Impacts on Perceived Health Care Quality and Public Health: The Case of Vietnam

Assessing the Socio-Economic Impacts of Rural Infrastructure Projects on Community Development

Public construction infrastructure projects have been recognized as one of the fundamental tools in enhancing community socio-economic conditions for community development. The purpose of this study is to empirically investigate the impacts of socio-economic factors on community development of rural regions. Through a questionnaire survey administrated in Pakistan, public construction practitioners’ views were sought and evaluated. Empirical support for the argument originated from the data collected from 213 respondents in Pakistan’s public construction industry. The questionnaire’s data were evaluated employing the partial least square structural equation modeling (PLS-SEM). The study’s findings showed that economic and social factors influence the community development of rural regions. The result obtained from PLS-SEM proposed a more viable method to realize community development and objectives. The study’s results have offered precious lessons for local authorities, policymakers, and project stakeholders to strengthen the drive for achieving community development goals. Strategies supporting community development in rural regions are indispensable for local community development. This study provides empirical confirmation for the understanding and combining the community development concept; it illuminates absent knowledge about community development, especially in rural regions. This is one of the few studies investigating the influencing dimensions of community development in rural regions. To the authors’ best knowledge, this is the first research article providing empirical evidence of the influencing dimensions of community development in rural regions in a developing country.

Improving Hospital's Quality of Service in Vietnam: The Patient Satisfaction Evaluation in Multiple Health Facilities

We developed a patient satisfaction (PS) scale to measure PS and determined associated factors with PS in several hospitals in Vietnam. In this cross-sectional survey, study on 108 patients in three hospitals in Hanoi, Vietnam was conducted. A PS instrument covering four domains: 1) Transparency of information and procedure; 2) Facilities and equipment; 3) Attitude and capacities of health professionals, and 4) Outcomes of service was used. Multivariate linear regression was performed to detect factors associated with patient satisfaction scores. The internal consistency reliability was excellent at 0.9400. The highest percentage of people having complete satisfaction was 64.8% in the item "Doctors have good attitudes and communication with patients," while the lowest percentage was in "the level of satisfaction with the price of medical services of the hospital" (13.0%). Overall, 23.2% of patients rated complete satisfaction with health services. There were 54.6%, 44.4%, 40.7%, and 26.9% patients having satisfaction/complete satisfaction with Outcomes of service, Facilities and Equipment, Attitude and capacities of health professionals and Transparency of information and procedure, respectively. Patients who were outpatients, living in other provinces, using on-demand services, and unable to pay service fees had lower levels of satisfaction compared to others. To conclude, the satisfaction with health service in our sample was moderately low, particularly transparency in information and procedure. Improving the quality of administrative procedures and the application of information technology are priority issues in improving the quality of hospitals and assure equality in health care delivery among different patient groups.

Evaluation of Inpatient Experience at Some Clinical Departments of Kien Giang General Hospital, Kien Giang Province, Vietnam, 2020: An Analytical Cross-Sectional Study

Patient experience is being widely considered in evaluating the quality of health care services. This is a cross-sectional study with 860 inpatients hospitalized in 4 clinical departments (General Internal Medicine; Cardiology; General Surgery; Surgery, and Orthopedic Trauma) of the Kien Giang General Hospital, from April to June 2020. Data was collected through a two-part questionnaire used to evaluate the inpatient experience during hospital treatment, using the Likert scale 5 points. The patient’s experience is classified into 3 aspects (environment—facilities, healthcare staff's care, treatment information). In total, 815 participants responded to the interview (94.8%). The rates of patients having a positive experience on the environment and facilities, the care of health workers, and treatment information are 31.7%, 85.9%, and 74.2%, respectively. The patient’s positive overall experience rate is 65.5%. Factors related to the patient's overall experience are the department of treatment, residential area, age, and employment status (P < .05). Overall, the positive experience of inpatients at some clinical departments of Kien Giang General Hospital was a relatively low rate (65.5%). Specifically, healthcare staff's care is experienced at a high rate, this factor should be continuously promoted. Improving and upgrading factors in the aspects of the environment—facilities and the treatment information should be implemented if the hospital wants to improve its quality of healthcare services.

Ranking the Healthcare Resource Factors for Public Satisfaction with Health System in China-Based on the Grey Relational Analysis Models

(1) Background: Public satisfaction with the health system is a very important comprehensive indicator. Given the limited healthcare resources in a society, it is always important for policymakers to have full information about the priority and the ranking order of the factors of healthcare resources for improving public satisfaction. (2) Methods: Grey Relational Analysis (GRA) is advantageous for satisfaction analysis because satisfaction is a “grey concept” of “having a clear boundary but vague connotation”. The data were from the CGSS and the China Health Statistics Yearbook (2013 and 2015), with a total of 15,969 samples (average satisfaction score = 68.5, age = 51.9, female = 49.4%). (3) Results: The government’s percentage of total expenditure on healthcare was ranked as the most important factor for public satisfaction with the health system in China in both 2013 and 2015. The second most important factor changed from “Out-of-pocket percentage of individuals” in 2013 to “Hospital beds per thousand populations” in 2015. Meanwhile, “Healthcare workforce per thousand populations” increased from the least important factor in 2013 to the 3rd in 2015. Disparities in the ranking orders of the factors among regions of China were identified too. (4) Conclusions: The analysis results suggest that during recent years the priority of Chinese residents’ healthcare satisfaction for healthcare resources has shifted on the national level from economic affordability to more intensive “people-centered” services, while the regional disparities and gaps need to receive more attention and be further improved in the healthcare reform of next round.

Public satisfaction with the healthcare system in China during 2013-2015: a cross-sectional survey of the associated factors

OBJECTIVE

We explore how public satisfaction with the healthcare system in China varies with social and economic factors, especially regional variations and changes during 2013-2015.

DESIGN

Population-based, cross-sectional survey performed between July 2013 and July 2015.

SETTING

General population of China during 2013-2015.

PARTICIPANTS

A total of 15 969 participants (women=49.4%, sample-weighted average age=51.9).

PRIMARY OUTCOME MEASURE

Public satisfaction with the healthcare system, defined as 'being satisfied' if a respondent's satisfaction score is ≥70 points.

RESULTS

The 2-year mean of the satisfaction score of the sample is 68.5 out of 100 points and the score in 2015 is higher than 2013 by 3.5 points. Senior respondents (OR=1.19, p<0.001), rural respondents (OR=1.23, p=0.009) and those with higher socioeconomic status are more likely to report being satisfied. Internal migrants (OR=0.75, p<0.001) and those with a higher level of education are less likely to report being satisfied. Total health expenditure as percentage of gross domestic product and density of hospital beds have a significantly positive association with satisfaction (OR=1.13, p<0.001). Meanwhile, the government's share in total healthcare expenditures has a moderately negative association with satisfaction (OR=0.97, p<0.001). In rural areas, the density of hospital beds has a positive association with satisfaction (OR=1.26, p=0.002). The Northeast region and Shanghai (OR=0.49, p<0.001; OR=0.71, p=0.034) are less likely to report being satisfied and this remained unchanged in 2015.

CONCLUSION

There are considerable disparities in public satisfaction with the healthcare system in China, associated with demographic and socioeconomic characteristics, regional locations, urban-rural environment, and regional health resource abundance. Actions are recommended to improve satisfaction with the public healthcare system, especially in the Northeast region of China.

The Role of Collaborative Healthcare in Improving Social Sustainability: A Conceptual Framework

Healthcare systems around the world face both increasing demands and inequality in service distribution. The current trend is for collaboration among healthcare actors, named as collaborative healthcare, in order to address challenges such as these to improve the social sustainability of the system. That is to provide accessible and equitable healthcare services to meet people’s health and well-being needs. Based on an integrative literature review, this study aims at crafting a conceptual framework to explore how collaborative healthcare networks contribute to social sustainability and the specific actors involved in these collaborations. It identifies relationships between different collaborative healthcare networks and social sustainability. Interprofessional networks have been the most studied in relation to social sustainability. Communication and sharing information or knowledge have been identified as used collaborative healthcare practices. This study contributes theoretically by considering a new model of the healthcare organization in which collaborative networks play a central role in improving social sustainability. In terms of practical implications, the study provides managers and policy makers with investment insights on a range of collaborative networks and practices.

A Scientometric Study on Depression among University Students in East Asia: Research and System Insufficiencies?

Given that mental health issues are acute in Asian countries, particularly Japan and Korea, and university students are more vulnerable to depression than the general population, this study aims to examine the landscapes of scientific research regarding depressive disorders among university students and evaluate the effectiveness of international collaboration and funding provision on the scientific impact in Korea, Japan, and China. Based on articles retrieved from the Web of Science database during the period 1992–2018, we found that the number of scientific publications, international collaborations, and allocated funds regarding depressive disorder among university students in China (97 articles, 43 international collaborations, and 52 funds provided, respectively) overwhelmingly surpassed the case of Korea (37 articles, 12 international collaborations, and 15 funds provided, respectively) and Japan (24 articles, 5 international collaborations, and 6 funds provided, respectively). The differences in collaboration patterns (p-value < 0.05) and the proportion of allocated funds (p-value < 0.05) among Korea, Japan, and China were also noted using Fisher’s exact test. Based on the Poisson regression analysis, China’s associations of scientific impact with international collaboration (β = −0.322, p-value < 0.01) and funding provision (β = −0.397, p-value < 0.01) are negative, while associations of the scientific impact and scientific quality with funding provision and international collaboration were statistically insignificant. These findings hint that Korea and Japan lacked scientific output, diversity in research targets, international collaboration, and funding provision, compared to China, but the quality of either China’s internationally collaborated or funded articles was contentious. As a result, policymakers in Korea and Japan are suggested to raise the importance of mental health problems in their future policy planning and resource distribution. Moreover, it would be advisable to establish a rigorous system of evaluation for the quality of internationally collaborated and funded studies in order to increase scientific impact and maintain public trust, especially in China.

A Dataset of Students’ Mental Health and Help-Seeking Behaviors in a Multicultural Environment

University students, especially international students, possess a higher risk of mental health problems than the general population. However, the literature regarding the prevalence and determinants of mental health problems as well as help-seeking behaviors of international and domestic students in Japan seems to be limited. This dataset contains 268 records of depression, acculturative stress, social connectedness, and help-seeking behaviors reported by international and domestic students at an international university in Japan. One of the main findings that can be drawn from this dataset is how the level of social connectedness and acculturative stress are predictive of the reported depression among international as well as domestic students. The dataset is expected to provide reliable materials for further study of cross-cultural public health studies and policy-making in higher education.

Sex Differences and Psychological Factors Associated with General Health Examinations Participation: Results from a Vietnamese Cross-Section Dataset

This study focuses on the association of sex differences and psychological factors with periodic general health examination (GHE) behaviors. We conducted a survey in Hanoi and the surrounding areas, collecting 2068 valid observations; the cross-section dataset was then analyzed using the baseline category logit model. The study shows that most people are afraid of discovering diseases through general health examinations (76.64%), and the fear of illness detection appears to be stronger for females than for males (β1(male) = −0.409, p < 0.001). People whose friends/relatives have experienced prolonged treatment tend to show more hesitation in participating in physical check-ups (β2 = 0.221, p < 0.05). On the ideal frequency of GHEs, 90% of the participants agree on once or twice a year. The probability of considering a certain period of time as an appropriate frequency for GHEs changes in accordance with the last doctor visit (low probability of a health examination every 18 months) and one’s fear of potential health problems post-checkup (no fear raises probability of viewing a health examination every 6 months by 9–13 percentage points). The results add to the literature on periodic GHE in particular and on preventive health behaviors in general.

The Dark Side of Female HIV Patient Care: Sexual and Reproductive Health Risks in Pre- and Post-Clinical Treatments

This study examines the pre- and post-clinical issues in human immunodeficiency virus (HIV) care and treatment for women and girls of high-risk population groups—namely sex workers, injecting drug users, women living with HIV, primary sexual partners of people living with HIV, adolescent girls who are children of these groups, and migrant young girls and women—in five provinces and cities in Vietnam. Through a sample of 241 surveyed participants and 48 respondents for in-depth interviews and 32 respondents in the focus group discussions, the study identifies multiple barriers that keep these groups from receiving the proper health care that is well within their human rights. Most respondents rated HIV testing as easily accessible, yet only 18.9% of the surveyed women living with HIV disclosed their infection status, while 37.8% gave no information at the most recent prenatal care visit. The level of knowledge and proper practices of sexual and reproductive health (SRH) care also remains limited. Meanwhile, modern birth control methods have yet to be widely adopted among these populations: only 30.7% of respondents reported using condoms when having sex with their husband. This increases the risks of unwanted pregnancy and abortion, as well as vulnerability to sexually transmitted infections (STIs) and HIV transmission. On the other hand, HIV-related stigma and discrimination at health care settings are still pervasive, which create significant barriers for patients to access proper care services. Based on these results, six recommendations to improve SRH status of women and girls of populations at high risk are put forward.

Factors Associated with the Regularity of Physical Exercises as a Means of Improving the Public Health System in Vietnam

Being ranked among the most sedentary countries, Vietnam’s social public health is challenged by the rising number of overweight people. This study aims to evaluate factors associated with the regularity of exercise and sports (EAS) among Vietnamese people living in the capital city of Hanoi, using data collected from a randomized survey involving 2068 individuals conducted in 2016. Physical exercises and daily sports are considered a major means for improving the Vietnamese social public health system by the government, families, and individuals. Applying the baseline-category logit model, the study analyzed two groups of factors associated with EAS regularity: (i) physiological factors (sex, body mass index (BMI)) and (ii) external factors (education, health communication, medical practice at home). Females with a university education or higher usually exercise less than those with lower education, while the opposite is true for males. The study also shows that those with a higher BMI tend to report higher activity levels. Additionally, improved health communication systems and regular health check-ups at home are also associated with more frequent EAS activities. These results, albeit limited to only one location in Vietnam, provide a basis for making targeted policies that promote a more active lifestyle. This, in turn, could help the country realize the goal of improving the average height of the population and reducing the incidents of non-communicable diseases.

The Effects of Health Status on Life Insurance Holdings in 16 European Countries

This study examines the relationships among three health status indicators (self-perceived health status, objective health status, and future health risk) and life insurance holdings in 16 European countries. Our results show that households with poor self-perceived health status and high future health risk are less likely to purchase life insurance in the entire sample as well as in the subsample for countries with a national health system (NHS). In non-NHS countries, those households that have high future health risk are less inclined to purchase life insurance. In terms of preferences for types of life insurance policies (term life, whole life, both, or none) in the whole sample, poor self-perceived health status and high future health risk are less inclined to hold only term life insurance policy. In addition, poor self-perceived health status and high future health risk have a negative impact on holdings of both types of life insurance. Our findings reveal that there is no adverse selection problem in the life insurance market, especially in European countries with NHS.

Health Care Payments in Vietnam: Patients' Quagmire of Caring for Health versus Economic Destitution

In the last three decades many developing and middle-income nations' health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing nations. This study investigates the status of Vietnam's current health system as a result of implementing user fees policies. A recent mandate by the government to increase the universal cover to 100% attempts to tackle inadequate insurance cover, one of the four major factors contributing to the high and increasing probability of destitution for Vietnamese patients (the other three being: non-residency, long stay in hospital, and high cost of treatment). Empirical results however suggest that this may be catastrophic for low-income earners: if insurance cover reimbursement decreases below 50% of actual health expenditures, the probability of Vietnamese falling into destitution will rise further. Our findings provide policy implications and directions to improve Vietnam's health care system, in particular by ensuring the utilization of health services and financial protection for the people.